Breast cancer: is the Pill a threat?

A recent study has identified that some women are at
greater risk of breast cancer if they take the contraceptive pill, but how big
is the risk and how worried should we be?

Some women who take the Pill may be at increased risk of
developing breast cancer.

Latest research

Research recently completed in Canada has shown that some women
are more at risk of developing
breast cancer if they
have used the
contraceptive pill
for five or more years.

The study, which was undertaken by the Centre for Research in
Women’s Health and the Women’s College Health Sciences Centre at the University
of Toronto, examined the medical history and oral contraceptive use of 1,311
pairs of women known to carry certain types of gene mutation.

The gene mutations apparently occur in women with a strong
family history of breast cancer – women with one relative under 40 years of age
who has had breast cancer, two under 60, or three of any age on the same side
of a family who have suffered from the disease.

The research found that women with the BRCA1 gene mutation and
who have used oral contraceptives for five or more years have a 33 per cent
increased risk of early onset of breast cancer, compared to women who have
never used birth control pills.

Dr Steven Narod and his team who carried out the research also
found elevated risk levels for women who used birth control pills before the
age of 30 and women who first used the pill before 1975.

Qualified risks

The researchers were careful to point out that their findings do
not mean that all women who take the contraceptive pill are at a great risk of
developing breast cancer.

In his report, Dr Narod stated firmly, 'The findings…are
relevant only to women who carry BRCA1 and BRCA2 gene mutations. In general the
pill does not appear to increase the risk of breast cancer in the wider
population.'

In the UK, it is estimated that between 5 and 10 per cent of the
39,000 breast cancers diagnosed each year are due to strong hereditary factors.
Of these, BRCA1 and BRCA2 account for around 80 per cent, with the former being
the more common.

At first glance, the report appears to pose a dilemma for women
under 30 who may wish to take the contraceptive pill. But Bernie Gardiner, an
information nurse specialist with Breast Cancer Care, says, 'It is
important that family history is taken into consideration when prescribing the
Pill so that an informed decision can be made.'

Delyth Morgan, chief executive of Breakthrough Breast Cancer,
supports this view, adding that the research provides important information for
women with a strong family history of breast cancer. '[They] can be given
clear advice about the pros and cons of taking the Pill in relation to their
own risk of developing the disease,' she says.

Confusing messages

Dr Richard Sullivan, head of clinical programmes at Cancer
Research UK, says he sympathises with women in the light of this report.
'There are so many messages coming out from different sources that it is
very confusing for women to know what they should be concerned about,' he
says.

'However, it must be borne in mind that hormone therapies,
such as the contraceptive pill and HRT, are considered a weak risk factor for
developing breast cancer, along with things like diet, being overweight,
alcohol and even being tall.'

Dr Sullivan continues, 'Women should not be unduly worried
about this particular report, unless they do have a strong family history of
breast cancer and then it is vital to consult with their doctor.

Experts warn that it is extremely important to bear in mind that
the study in no way suggests the Pill causes an increased breast cancer risk
for all women, as there are advantages of taking it, for example a reduction in
the risk of
ovarian
cancer.

Talk to the experts

Obviously the report’s findings need to be kept in perspective.
Pill-users can be reassured that firstly the number of women in the high-risk
bracket is relatively small and secondly that breast cancer is rare in young
women, particularly in the age groups most likely to consider use of the
contraceptive pill.

The simple advice if you are thinking about going on the Pill is
to consult your doctor so that he/she has all relevant information about your
family history and can prescribe the contraceptive safely, say
experts.

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